Definition: An acute infection of the middle ear cleft (including the eustachian tube)
Causative organisms StreptococcusPneumoniaeHaemophilusInfluenzaeMoraxellaCatarrhalisPresenting symptoms:There is a sharp pair in ear with which patients usually present with as the middle ear clefts volume is very small, so if there is purulence then it expands resulting in pain. Patients do not present with fever as there is widespread misuse of antibiotics which leads to drug resistance. acute suppurative otitis media may present with sinusitis or URTI where the offending organism may travel up the eustachian tube to the middle ear. Patients even present with vertigo as their is some serous labyrinthitis as a complication of middle ear infection. In each such patients arbitrary antibiotic therapy is to be avoided. Age of Presentation : Almost every body has had an attack of AOM as a child as the Eustachian tube is shorter& straighter in childhood. Plus breast feeding mothers cause AOM to their own infant as they breast milk feed in faulty position.Signs :The ear drum is usually a fiery red coloured drum the cart wheel drum. In a few cases the ear drum may look normal as the disease is just starting.Stages of disease: Catarrhal stage Infective stage Active inflammation Stage of purulence Stageof resolution In infants this is a self curing entity as mothers milk has the appropriate antibodies to tackle the situation. Treatment : The first line of drug is usually Amoxycillin, clavulanate combination. Cephalosporinmay be used as Cefpodoxime and Clavulanate. Use of drugs for sinusitis, accompanying serous labyrinthitis requires the judicious use of antibiotics and anti vertigo treatment as previously mentioned. Thesedays role of clavulanic acid has increased in the treatment of recurring or persisting acute otitis media.Complication of AOM :Serous labyrinthitis, Chronic suppurative otitis media, Purulent labyrinthitis. This usually does not occur as ear pain is judged by any health professional and their is use of antibiotics. Use of decongestant nasal spray is vital in curing AOM & the accompanying pain as in such cases the Eustachian tube get unblocked and so there is relief from pain.